A novel way to reconstruct the neglected achilles tendon rupture

Neglected (chronic) rupture of the Achilles tendon is an uncommon injury, for which the optimal treatment is operative repair.9 Despite many repair techniques for the condition having been described, the current literature does not allow clinicians to definitively determine the optimal operative technique for successful tendon repair.5 The various turndown flaps that may be utilized in the repair of a chronically ruptured Achilles tendon have been summarized in the literature,7,11 and modified techniques continue to evolve.2 In 1959, Lindholm 10 described a technique to augment Achilles tendon repair by turndown of the gastrocnemius fascia. This repair is bulky and can cause discomfort for the patient. In this article, we describe a novel technique that eliminates the bulk by incorporating a free flap interpositional graft to the Achilles tendon defect. Early data suggest that our technique provides an excellent clinical result.Vipin Asopa, Robert J. Douglas, and James J. Clayto